SANITIZED SANITIZED SANITIZED SANITIZED Authority: 1949 PA 300, Sec.257.

622
Compliance: Required MSP UD-10E
External # Crash ID Page 01 of 02

Penalty: $100 and/or 90 days (Rev 01/2016)

1081609 1185073 File Class

Incident #
STATE OF MICHIGAN TRAFFIC CRASH REPORT 1081609
ORI Department Name Reviewer
MI 8234903 Detroit Police Department 3 JASON KLEINSORGE
Crash Date Crash Time No. of Units Crash Type Special Circumstances Special Checks
None Hit and Run School Bus Fatal Non-Traffic Area ORV/Snowmobile
11/06/2017 13:15 03 Other Fleeing Police Unknown Animal
County Traffic Control Relation to Roadway Weather Area
82 - Wayne Signal On the Road Clear INTR Within Intersection
City/Twsp Contributing Circumstances Light Road Surface Condition Total Lanes Speed Limit Posted
1st 2nd
99 - Detroit Daylight Dry 09 30 Yes
None
Work Zone (if applicable)
Type Workers Present Activity Location
LOCATION

Prefix Primary Road Name Road Type Suffix Divided Roadway

WOODWARD AVE
Distance / Direction Trafficway
25 Feet S Divided Hwy with Barrier
Prefix Intersecting Road Name Road Type Suffix Divided Roadway
CANFIELD
Unit Number Unit Known State Driver License Number Date of Birth (Age) License Type Endorsements Sex Total Occupants Hazardous Action
01 Yes MI ############# ##/##/#### (26) Operator Cycle F 02 Unable to Stop
Chauffeur Farm
Moped Recreation
Unit Type Driver Information Driver is Owner Injury Position Restraint
MV ############################## No O Front - Left Restraint Use Unknown
##############################
DETROIT, MI 48219 (###) ###-####
Driver Condition at Time of Crash Driver Distracted By Ejected Trapped Airbag Deployed
1st 2nd
Unknown Not Equipped
Appeared Normal
U N I T / D R I V E R

Hospital Ambulance
NONE NONE
Alcohol Suspected Contributing FactorAlcohol Test Type Alcohol Test Results Interlock Device
No No Breath Blood Urine Pending Test Results: No
Field PBT Refused Not Offered
Drug Suspected Contributing Factor Drug Test Type Drug Test Results Citation Issued
No No Blood Urine Pending Test Results: Hazardous
Field Refused Not Offered Other FAIL TO STOP W/IN ASSURED CLEAR
Vehicle Registration State Vehicle Year Make Model Color
083X060 MI Description 2010 NEW FLYER BUS WHI
VIN Vehicle Type Special Vehicles Private Trailer Type Vehicle Defect
5FYD4FV19AB036995 Truck / Bus Bus
Insurance Company Insurance Policy # Towed By Towed To
############################## ############################## N/A N/A
Location of First Impact Extent of Damage (Power Unit and/or Trailers) Vehicle Direction Vehicle Use Action Prior
Greatest Damage 02 02 Minor Damage S Commercial (Business) Changing Lanes
Sequence of First Second Third Fourth
Events 19 - Engineer (Railroad/Train)
( indicates MOST harmful event)

Passenger Information Date of Birth (Age) Sex Position Restraint

############################## ##/##/#### (56) M Other Unenclosd Passenger Restraint Use Unknown
############################## Injury Ejected Trapped Airbag Deployed
DETROIT, MI ### (###) ###-#### O Not Equipped
Hospital Ambulance
NONE NONE
PASSENGERS

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Carrier Information USDOT MC MPSC

TRUCK/BUS

DEPT OF TRANSPORTATION
1301 E WARREN AVE Driver's CDL Type Endorsements CDL Exempt
DETROIT, MI 48224 Group B H P T Farm
N S X Other
GVWR/GCWR Vehicle Configuration Cargo Body Type Medical Card Hazardous Material ID # Class #
10,000 lbs. or Less 10,001 - 26,000 lbs. Greater than 26,000 lbs. Bus 16+ 14 Yes Placard Cargo Spill

Owner Information Owner Information

OWNERS

Damaged Property Public Owner & Phone

SANITIZED SANITIZED SANITIZED SANITIZED Unit Number Unit Known State Driver License Number Date of Birth (Age) License Type Endorsements Sex Total Occupants Hazardous Action
02 Yes MI ############# ##/##/#### (73) Operator Cycle M 02 None
Chauffeur Farm
Moped Recreation
Unit Type Driver Information Driver is Owner Injury Position Restraint
MV ############################## No C Front - Left Shoulder and Lap Belt
##############################
DETROIT, MI 48214 (###) ###-####
Driver Condition at Time of Crash Driver Distracted By Ejected Trapped Airbag Deployed
1st 2nd
Not Distracted Not Deployed
Appeared Normal
U N I T / D R I V E R

Hospital Ambulance
VHS DETROIT RECEIVING HOSPITAL INC DETROIT FIRE DEPT EMS
Alcohol Suspected Contributing FactorAlcohol Test Type Alcohol Test Results Interlock Device
No No Breath Blood Urine Pending Test Results: No
Field PBT Refused Not Offered
Drug Suspected Contributing Factor Drug Test Type Drug Test Results Citation Issued
No No Blood Urine Pending Test Results: Hazardous
Field Refused Not Offered Other
Vehicle Registration State Vehicle Year Make Model Color
DHS4518 OH Description 2010 BUICK CENTURY RED
VIN Vehicle Type Special Vehicles Private Trailer Type Vehicle Defect
2G4WY55J3Y1205101 Passenger Car, SUV, Van Not Applicable
Insurance Company Insurance Policy # Towed By Towed To
############################## ############################## GENES GENES TOW CO
Location of First Impact Extent of Damage (Power Unit and/or Trailers) Vehicle Direction Vehicle Use Action Prior
Greatest Damage 06 06 Disabling Damage S Private Slowing/Stop on Roadway
Sequence of First Second Third Fourth
Events 19 - Engineer (Railroad/Train)
( indicates MOST harmful event)

Passenger Information Date of Birth (Age) Sex Position Restraint

############################## ##/##/#### (51) F Front - Right Restraint Use Unknown
############################## Injury Ejected Trapped Airbag Deployed
DETROIT, MI ### (###) ###-#### C Not Equipped
Hospital Ambulance
VHS DETROIT RECEIVING HOSPITAL INC DETROIT FIRE DEPT EMS
PASSENGERS

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Carrier Information USDOT MC MPSC

TRUCK/BUS

Driver's CDL Type Endorsements CDL Exempt

H P T Farm
N S X Other
GVWR/GCWR Vehicle Configuration Cargo Body Type Medical Card Hazardous Material ID # Class #
10,000 lbs. or Less 10,001 - 26,000 lbs. Greater than 26,000 lbs. Placard Cargo Spill

Owner Information Owner Information

WITNESS OWNERS

Witness Information Witness Information

Investigated Reported Date (Time) 1st Investigator Name (Badge) 2nd Investigator Name (Badge) Photos
at Scene Yes 11/06/2017 (14:49) RONALD LACH (3603) Yes
Narrative Diagram
Driver of veh #1 states vehicle #2 began to slow in front of her, #1 began to
change lanes from the middle lane of s/b Woodward to the left lane, when #2
must of stopped when #1 rearended veh #2, #2 than struck the Qline train which
was stopped. Driver of veh #2 was interviewed at D.R.H. who states he was
slowing down next to the Qline train, which was stopped loadind/unloading
passengers, and about to turn right into the Mcdonalds parking lot when he was
rearended by vehicle #1 and pushed into the Qline train. Qline terain operator
(#3) confirms above statements, stating he was stopped loading/unloading
passengers. Driver of veh #1 was cited for accident.
SANITIZED SANITIZED SANITIZED SANITIZED Authority: 1949 PA 300, Sec.257.622
Compliance: Required MSP UD-10E
External # Crash ID Page 02 of 02

Penalty: $100 and/or 90 days (Rev 01/2016)

1081609 1185073 File Class

Incident #
STATE OF MICHIGAN TRAFFIC CRASH REPORT 1081609
ORI Department Name Reviewer
MI 8234903 Detroit Police Department 3 JASON KLEINSORGE
Crash Date Crash Time No. of Units Crash Type Special Circumstances Special Checks
None Hit and Run School Bus Fatal Non-Traffic Area ORV/Snowmobile
11/06/2017 13:15 03 Other Fleeing Police Unknown Animal
County Traffic Control Relation to Roadway Weather Area
82 - Wayne Signal On the Road Clear INTR Within Intersection
City/Twsp Contributing Circumstances Light Road Surface Condition Total Lanes Speed Limit Posted
1st 2nd
99 - Detroit Daylight Dry 09 30 Yes
None
Work Zone (if applicable)
Type Workers Present Activity Location
LOCATION

Prefix Primary Road Name Road Type Suffix Divided Roadway

WOODWARD AVE
Distance / Direction Trafficway
25 Feet S Divided Hwy with Barrier
Prefix Intersecting Road Name Road Type Suffix Divided Roadway
CANFIELD
Unit Number Unit Known State Driver License Number Date of Birth (Age) License Type Endorsements Sex Total Occupants Hazardous Action
03 Yes ############# ##/##/#### (35) Operator Cycle M 01 None
Chauffeur Farm
Moped Recreation
Unit Type Driver Information Driver is Owner Injury Position Restraint
E ############################## No O Engineer No Belts Available
##############################
DETROIT, MI 48224 (###) ###-####
Driver Condition at Time of Crash Driver Distracted By Ejected Trapped Airbag Deployed
1st 2nd
Not Distracted Not Equipped
Appeared Normal
U N I T / D R I V E R

Hospital Ambulance
NONE NONE
Alcohol Suspected Contributing FactorAlcohol Test Type Alcohol Test Results Interlock Device
No No Breath Blood Urine Pending Test Results: No
Field PBT Refused Not Offered
Drug Suspected Contributing Factor Drug Test Type Drug Test Results Citation Issued
No No Blood Urine Pending Test Results: Hazardous
Field Refused Not Offered Other
Vehicle Registration State Vehicle Year Make Model Color
290 Description 2015 BROOKVILLE LIBERTY STREET WHI
VIN Vehicle Type Special Vehicles Private Trailer Type Vehicle Defect
15015 Other Not Applicable
Insurance Company Insurance Policy # Towed By Towed To
############################## ############################## N/A N/A
Location of First Impact Extent of Damage (Power Unit and/or Trailers) Vehicle Direction Vehicle Use Action Prior
Greatest Damage 07 07 Minor Damage S Other Stopped on Roadway
Sequence of First Second Third Fourth
Events 17 - Motor Veh in Transport
( indicates MOST harmful event)

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance
PASSENGERS

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Carrier Information USDOT MC MPSC

TRUCK/BUS

Driver's CDL Type Endorsements CDL Exempt

H P T Farm
N S X Other
GVWR/GCWR Vehicle Configuration Cargo Body Type Medical Card Hazardous Material ID # Class #
10,000 lbs. or Less 10,001 - 26,000 lbs. Greater than 26,000 lbs. Placard Cargo Spill

Owner Information Owner Information

OWNERS

##############################
##############################
###################################, ## #####-#### (###) ###-####

Damaged Property Public Owner & Phone

SANITIZED SANITIZED SANITIZED SANITIZED Unit Number Unit Known State Driver License Number Date of Birth (Age) License Type Endorsements Sex Total Occupants Hazardous Action
Operator Cycle
Chauffeur Farm
Moped Recreation
Unit Type Driver Information Driver is Owner Injury Position Restraint

Driver Condition at Time of Crash Driver Distracted By Ejected Trapped Airbag Deployed
1st 2nd
U N I T / D R I V E R

Hospital Ambulance

Alcohol Suspected Contributing FactorAlcohol Test Type Alcohol Test Results Interlock Device
Breath Blood Urine Pending Test Results:
Field PBT Refused Not Offered
Drug Suspected Contributing Factor Drug Test Type Drug Test Results Citation Issued
Blood Urine Pending Test Results: Hazardous
Field Refused Not Offered Other
Vehicle Registration State Vehicle Year Make Model Color
Description

VIN Vehicle Type Special Vehicles Private Trailer Type Vehicle Defect

Insurance Company Insurance Policy # Towed By Towed To

Location of First Impact Extent of Damage (Power Unit and/or Trailers) Vehicle Direction Vehicle Use Action Prior
Greatest Damage

Sequence of First Second Third Fourth

Events
( indicates MOST harmful event)

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance
PASSENGERS

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Passenger Information Date of Birth (Age) Sex Position Restraint

Injury Ejected Trapped Airbag Deployed

Hospital Ambulance

Carrier Information USDOT MC MPSC

TRUCK/BUS

Driver's CDL Type Endorsements CDL Exempt

H P T Farm
N S X Other
GVWR/GCWR Vehicle Configuration Cargo Body Type Medical Card Hazardous Material ID # Class #
10,000 lbs. or Less 10,001 - 26,000 lbs. Greater than 26,000 lbs. Placard Cargo Spill

Owner Information Owner Information

WITNESS OWNERS

Witness Information Witness Information

Investigated Reported Date (Time) 1st Investigator Name (Badge) 2nd Investigator Name (Badge) Photos
at Scene

Narrative Diagram